Greater Efficiency In The Prescription Department

IN

THE

Prescription Department By Charles C. Rabe*

Professor Rabe observes that prescri ption department design and storage are too closely tied with tradition, and not sufficiently related to actual present-day practice.

gain to the pharmacist, it would tend to make his work-load lighter. Status of Prescription Chemicals

I

has long been efficiency-minded, because both labor and management gain as a r:esult. Machines and materials have been placed in locations that reduce the amount . of work required for even the most simple operations. Not all pharmacists have given the same thorough attention to promoting efficiency in the prescription department. A survey of a number of representative pharmacies revealed that · a rearrangement of stock according to frequency of usage could bring about a marked reduction in the amount of work that goes into filling a day's prescriptions. While this lpightnot · result in direct economic NDUSTRY

Presented before the Section on Practical Pharmacy, A.PH.A. Convention, Salt Lake City, Utah, August, 1953. * Associate Professor of Pharmacy Administration, St. Louis College of Pharmacy and Allied Sciences, St. Louis 10, Mo.

584

The prescription departments of many pharmacies have undergone little change in past years, that is, except for the presence of the many new, trademarked products. One unchanged feature is the display of chemicals at the prescription counter. Even in some of the more recently established stores, one finds an array of a complete line of chemicals occupying this same choice space. No objection is raised to the presence of chemicals, but rather the fact that they have been given such valuable space at the work counter, whereas the products that the pharmacist uses more regularly have been placed at points rather distant from the counter. One cannot question the fact that a display of chemicals lends professional atmosphere; however, they must be seen by the people wJlOm we wish to impress, and that it is not the case in many pharmacies. If chemicals are to be displayed for effect, they should be placed on higher-level shelving facing the customers. Let us prove our point that a complete line of chemicals does not rate premium space at the prescription counter on the basis' of frequency of usage. A tabulation was made of two hundred and fifty prescriptions filled in each of five pharmacies in the St. Louis area. Table I shows that only a limited number of these prescriptions involved the use of chemicals, the range being from 3 per cent to 14 per cent. The number of different chemicals used ranged from seven to twentyVol. XIV, No.9

PHACTICAL PHARMACY EDITION

three, only about half of which received more than on!' sp!'cification. TABLE 1.-

2.50

·JlRHQlFENCY OF USE of CHEMICALS IN PRESCRIPTIONS IN EACH OF FIVE PHARMACIES

:-\0.

Store Number

Prescriptions Involving Chemicals

1

2 3 4

5

:--Jo. No. Different Chemicals Chemicals Used More Used Than Once

25 20

2:3 22

19 is 35

17 7

23

14 .S 7 3 ].S

It is not possible to list a model stock that would apply to all stores, since the prescribing habits of physicians vary from one area to another. This was evidenced by the fact that forty-nine different chemicals did appear in the total number of prescriptions tabulated, although twenty-one of these were used only once. There is no doubt that the number of chemicals stocked at most prescription counters could be reduced to some twenty or twenty-five, the remaining chemicals being removed to another area of the department.

Unnecessary Steps

Let us cite a few examples of the need for a rearrangement of stock, as observed in "isits to various stores. One pham1acy filling about one hundred prescriptions per day was receiving an average of three calls per day for a popular anticholinergic product. The stock bottle of this product was located seven steps from the counter where the tablets would be counted and packaged. The filling of one such prescription would thus require the phannacist to take twenty-eight steps, or a total of more than eighty steps for the three prescriptions. This same phannacy had an array of chemicals at the prescription counter numbering nearly two hundred, many of which were of such age that their labels were hardly legible. A rearrangement of stock on the basis of frequency of usage could have eliminated practically all of the previously cited eighty steps. In other pharmacies, it was noted that the broad spectrum antibiotic capsules were kept in drawers, cabinets, or on shelving some distance from the work counter. It is true that these items received limited specifications during certain seasons, yet they are active and should be kept within close reach. The same situation was found to exist in regard to soluble and buffered penicillin tablets. Countless other examples could be mentioned, but it is unnecessary to do so; this is known to be a rather general condition. September, 1953

Efficiency Sacrificed for Tradition

A number of arguments have been advanced against replacing slow-moving chemicals with fast-moving products. Busy prescription-type pharmacies with several work counlers oftI'll prefer to keep their stock bottles of specialties centrally located; such an arrangement is generally the most efficient in their type of operation. But other pharmacists, many of them in stores having only one counter, state that it is easy to find stock when arranged alphabetically or by manufacturers' groupings, and they are afraid that confusion might result from making any changes. There is logic to such arguments, but it would appear that it is largely a matter of sacrificing efficiency for tradition. But it must be admitted that an arrangement of specialties at the prescription counter might take on a cluttered look if the phannacist did not cull out slow-moving items from time to time. (Continued on page 598)

Author's Summary Only a limited number of chemicals rcceive frequent specifications, yet many pharmacies continue to devote premium space at the prescription counter to a complete line of such products. Fast-moving specialties are often stocked seme distance from the work counter, thus requiring the pharmacist to take hundreds of unnecessary steps each day. Thc slow-moving chemicals should be removed from the prescription coun ter and replaced by fast-moving products. A rearrangcnlCnt of prescription containers would reduce the number of back-bending motions made by pharmacists in many stores. There is resistance to change in the manner of doing things in the prescription _ department largely due to tradition. '----------~- ...- .

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JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION

Prescription Department • • • • • • • • • • • • • from page 585

The marketing of a multitude of new products will make this a very necessary task. The release of such products does hamper over-all efficiency, but it is unlikely that pliarmacists wi1l ever be able to beat the problem into submission by means of attacks against a free-enterprise, pharmaceutical industry. Further evidence of the effect of tradition was noted in the storage of prescription containers. It was observed that many pharmacists were making back-bending motions that could have been avoided through a more efficient arrangement of such containers. One example will illustrate the point. Our analysis of prescriptions showed that the four-fluid-ounce bottle is the most frequently used size of this type of glassware. And yet we found that it is generally stocked in one of the lower drawers at the prescription counter. Recommendations

In order to determine which of the chemicals should be removed from the prescription counter to make space for other products, it is suggested that the pharmacist analyze several hundred prescriptions fined during the winter and summer

months. While it is difficult to recommend that a specific number of prescriptions be studied, there is good reason to believe that those filled during a period of one week in each of the two above-mentioned seasons would be adequate in many instances. If the pharmacist does not wish to tabulate by this method, it is suggested that he attach strip labels to the chemical bottles for a period of one or more weeks, and place a notation on them when used. Determining which of the fast-moving specialty products should be placed at the prescription counter~ or within clo~e proximity, is not an easy matter, because the picture changes with the release of newer products. Since an analysis of prescriptions at such frequent intervals might be too time-consuming, the pharmacist should rely more on his experience in making these selections. Company catalogues, textbooks on pharmacology, and several published prescription surveys provide a listing of therapeutic groups. The pharmacist should study such groupings and attempt to list the several products in each category which receive the most frequent calls in his store. And, of course, the number of such products to be seJected would depend upon the amount of space made available at the prescription counter as the result of removing slow-moving chemicals.

PECTIN N.F. (PURIFIED POLYGALACTURONIC ACID METHYL ESTER)

FOR MEDICINAL AND PHARMACEUTICAL USES

• Made from Our Own California Citrus Fruits Also regularly supplied fo pharmaceutical firms:

Sodium Calcium Galacturona.te Hesperidin Methyl Chalcone Lemon Peel Infusion, dried Pectin N. F. with dextrose Citrus Bioflavonoids Sodium PolypectatF Pectin Albedo Pectin, 1. M Pectic Acid Hesperidin Naringin

• SUNKIST GROWERS PRODUCTS DEPARTMENT. ONTARIO, CALIF.

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Vol. XIV, No.9